Autism Therapy: cognitive-behavioral therapy (CBT)

Since very little information is provided here on CBT (though you can certainly find alot from searching the web) I thought I would add some. I am not very knowledgeable about autism so I am not sure how effective a treatment CBT would be. It would require the client to be able to process ideas and have some basic self-awareness of his/her thinking - i.e., they need to be able to think about their thinking.

The reason for this is that in CBT, one examines, with the help of a skilled teacher (CBT is largely a learning experience), one's habits of thinking going down to one's fundamental attitudes and beliefs. I think that all of us have some thought patterns and attitudes that are not helpful (some schools of CBT call them irrational). With the help of the teacher, the client learns which of his/her thoughts, beliefs and attitudes are helpful and which are harmful. They then work on practicing changing the harmful ones to more helpful ones. Since behavior is largely a function of our thinking, one would expect the behavior to change as a result, and that is the idea but we must remember that we have been practicing our thinking and behavior pattens for a long time and they don't usually just change suddenly. It's easier to change the thoughts first and then practice with the feelings and behaviors until they begin to feel as natural as the old less functional ones did.

If the autism is not so bad that the client cannot do this kind of mental processing I imagine CBT could be very helpful, especially in combination with other therapies. The hardest thing I have found is locating a good CBT therapist. My experience comes from the Albert Ellis - Maxie Maultsby school of CBT that whent by many similar names. Ellis began calling his method RET for Rational Emotive Therapy. Maultsby modified RET to make it easier to use by lay groups and for self-counseling and called his RBT for Rational Behavioral Therapy. While I and many people I know found RBT extremely beneficial and also teachable to others, it never caught on. Currently Dr. Aldo Pucci is carrying on the RBT tradition with his Rational Living Therapy and CBT itself has become a respected form of therapy, though there is no clear definition and you will find many different types of therapists who call themselves CBT therapists. In my opinion, good CBT is systematic, makes sure it goes to the heart of the clients thought and attitude patterns, successfully helps the client challenge and change unhelpful or irrational thinking patterns and attitudes and prescribes practice that will make those changes stick. Again my opinion, the CBT therapist has to know his/her method very well and have applied it successfully to themselves. This is not a do as I say, not as I do approach! So if you use a CBT therapist and after a few sessions it doesn't seem to be working, don't assume CBT won't work. It may be the therapist so see if you can find a better one.

Good luck with CBT

Robin Alexander, www.transthought.org